HEADACHE / MIGRAINE DIARY TEMPLATE

Use this to track frequency, duration, severity, prostrating behavior, and work/daily-life impact.

Date:
Start time:
End time:
Total duration:
Pain severity 0-10:
Location / type of pain:

Symptoms:
- nausea
- vomiting
- light sensitivity
- sound sensitivity
- aura / visual changes
- dizziness
- cognitive fog
- tinnitus / ringing
- weakness
- speech difficulty
- fatigue
- other:

Did I have to stop activity? yes / no
Did I have to lie down? yes / no
Dark/quiet room needed? yes / no
Medication taken:
Did medication help? yes / no / partly
Recovery time after headache:

Work impact:
- missed work
- left early
- reduced productivity
- unsafe to drive
- had to cancel task/appointment
- other:

Household / family / social impact:

Possible trigger:
Sleep impact:
Notes:
